Asociación de Hemato-Oncología Pediátrica de Centro América (AHOPCA): A model for sustainable development in pediatric oncology

Abstract

Bridging the survival gap for children with cancer, between those (the great majority) in low and middle income countries (LMIC) and their economically advantaged counterparts, is a challenge that has been addressed by twinning institutions in high income countries with centers in LMIC. The long-established partnership between a Central American consortium--Asociación de Hemato-Oncología Pediátrica de Centro América (AHOPCA)--and institutions in Europe and North America provides a striking example of such a twinning program. The demonstrable success of this endeavor offers a model for improving the health outcomes of children with cancer worldwide. As this remarkable enterprise celebrates its 15th anniversary, it is appropriate to reflect on its origin, subsequent growth and development, and the lessons it provides for others embarking on or already engaged in similar journeys. Many challenges have been encountered and not all yet overcome. Commitment to the endeavor, collaboration in its achievements and determination to overcome obstacles collectively are the hallmarks that stamp AHOPCA as a particularly successful partnership in advancing pediatric oncology in the developing world.

Social and economic determinants of pediatric health inequalities: the model of chronic kidney disease

“…(v) The case of the chronic kidney diseases, which has been explored as a model condition, is by no means alone. The wide and orphan range of disabilities is certainly a further priority (20), but other chronic pediatric disorders, from cancer to rheumatic diseases, are now seen as essential components of health care, also in many deprived countries (21,22).…”

Improving Care for Children With Cancer in Low- and Middle-Income Countries-A SIOP PODC Initiative

“…A detailed description of each of these is beyond the scope of this article and the interested reader can look at the recent reviews for specifics. [2,6,7] It is worth emphasizing that the socioeconomic circumstances of the individual patient/parent are critical to the outcomes, but so is the national context. Indeed, annual government healthcare expenditures correlate strongly with childhood cancer survival.…”

“…[5] In some LIC, children comprise 40-50% of the population, and the proportion of childhood cancers represents 3-10% of cancer cases, [8] whereas in HIC, this proportion is only about 1%. [8] Mortality patterns also differ since cancer accounts for 4-5% of childhood deaths in HIC (where cancer is the leading cause of death from disease among children aged [1][2][3][4][5][6][7][8][9][10][11][12][13][14], and less than 1% in LMIC (where deaths from infectious diseases are more prominent). [5] In this article, we summarize the recent progress of the Paediatric Oncology in Developing Countries (PODC) committee of the International Society of Paediatric Oncology (SIOP) to address the disparities in treatment and outcomes of childhood cancer in LMIC.…”

In the realms of future: new frontiers of ‘techno-oncology’ as a platform for global improvement in the outcomes of childhood cancer

“…Developing a sustainable model for growth and development of pediatric cancer programs is a relevant goal for technooncology. In fact, the ultimate long-term goal of transfer of technology, collaboration and partnerships should be to build self-sustainable pediatric cancer treatment centers in LMICs [7,9].…”

“…However, recently, efforts in the endeavor to improve the cancer outcomes in developing nations have diversified. Remarkable success has been achieved by twinning programs, partner sites in high-income countries (HIC), shared care and training of local personnel and health care workers to build expertise in pediatric oncology [7][8][9]. Clearly, a holistic and multimodal approach addressing a multitude of issues, including high rates of therapy abandonment, relapse and mortality in developing nations; complex financial and socioeconomic factors in developing nations; social and cultural factors influencing therapy decisions; local health care system and personnel issues and development of sustainable, adaptable and successful local research and health care system is needed to improve the outcomes of pediatric oncology patients in developing nations.…”